Surgical scapels

A hospital trust in the West Midlands has failed in a legal bid to force a woman whose infected foot "came off" to have a potentially lifesaving operation to save her gangrenous leg.

Judges ruled the "strong-willed" woman was within her legal rights to refuse the operation and that medics could not force her to, even if her decision ultimately proves fatal.

The woman in her sixties, referred to in court as JB, had a superficial ulcer on the skin of her foot which started in May. By the time she was admitted to hospital on New Years' Eve, the Birmingham Mail reports, "Her right foot was now entirely mummified and, by the end of January, it had come off, leaving an unresolved wound."

Her wound has deteriorated, due to ongoing health issues including diabetes and circulation problems, exacerbated by JB's smoking.

Doctors had informed JB they needed to amputate her leg to protect her and stop the gangrene from spreading, but JB has steadfastly refused. Lawyers representing the Heart of England NHS Foundation Trust took her case to the Court of Protection in London in a bid to win permission to carry out the op without the woman's agreement. They argued that the woman's history of paranoid schizophrenia meant she "lacked capacity" to make a decision about the amputation for herself.

But judges disagreed. Justice Peter Jackson ruled her previous mental illness had not robbed her of the power to make rational decisions, and her doctors would have to respect her decision and honour her wishes.

"The freedom to choose for oneself is a part of what it means to be human. My conclusion is that JB undoubtedly has a disturbance of the functioning of her mind in the form of paranoid schizophrenia, as to which she lacks insight.

"But it has not been established that she thereby lacks the capacity to make a decision about surgery for herself. On the contrary, the evidence establishes that she does have capacity to decide whether to undergo an amputation of whatever kind."